ABSTRACT: CLINICAL CORE The mission of the University of Kansas (KU) ADC's Clinical Core is to stimulate and support clinical and translational research in brain aging and Alzheimer's disease (AD). The Clinical Core does this by providing data, biological samples, research participants, and infrastructure to support local and regional research endeavors. The Clinical Core also contributes importantly to national research initiatives (such as NACC, NCRAD, ADNI, and ADCS programs). In our first funding cycle, the Clinical Core met its enrollment goals, supported a broad and growing base of research activity, established a well-functioning autopsy program, and launched a portfolio of investigator-initiated clinical trials testing the effect of manipulating metabolism (i.e., exercise, diet, pharmacological approaches) as a potential therapeutic approach for AD. The Clinical Core stimulates and supports AD and aging research by providing investigators with well- characterized participants and biological specimens. In our first funding cycle, we supported 74 studies with 836 enrollments (506 unique participants) and the distribution of 2,453 biological specimens. We have strengthened our participant recruitment capabilities with two ancillary trial-ready cohorts. To advance our scientific theme of the role of altered energy metabolism in brain aging and AD, we assist investigators with metabolic assessments (i.e., aerobic fitness, body composition, and insulin resistance). Our integrated, financially-independent Clinical Trial Unit participates in national initiatives and provides expertise and support for early-stage clinical trials, including trials testing the therapeutic potential of manipulating energy metabolism. During the next funding cycle, the Clinical Core will continue to maintain an active Clinical Cohort (n=400) of cognitively normal (CN), mild cognitive impairment (MCI), and AD participants to support local and national studies. Fasting blood samples are obtained at entry and every 4 years thereafter. The Clinical Core provides postmortem tissue for the Neuropathology Core through our voluntary autopsy program. The Clinical Core also collects data on important lifestyle measures of physical activity, sleep, and diet through surveys and wearable technology. We have successfully created a robust foundation and now intend to strengthen and extend this foundation through broader and more efficient participant recruitment methods, enhanced lifestyle and fitness assessments on our Clinical Cohort, and by expanding our work within the theme of the role of energy metabolism in brain aging and AD. The infrastructure and expertise of the Clinical Core is enabling new avenues of research into AD prevention and treatment.